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Exam Questions Flashcards

1
Q

Upper respiratory tract infections are mostly caused by which of the following:

A

virus

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2
Q

Exposure to volatile chemicals found in cigarettes is the main cause of emphysema.

A

true

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3
Q

This middle respiratory tract infection causes inflammation to the larynx and a barking cough in infants:

A

croup

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4
Q

Enlarged airspaces beyond the respiratory tubules are a way of describing which of the following?

A

emphysema

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5
Q

What mineral do patients with cystic fibrosis have trouble reabsorbing?

A

chlorine

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6
Q

Which of the following is the most common cause of a pulmonary embolism?

A

DVT

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7
Q

Antibiotics are NOT a treatment for which of the following pathologies:

A

common cold

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8
Q

Excessive production of mucus in the lumen of the bronchioles causing cough and expectoration for at least 3 months during the last 2 years is called:

A

chronic bronchitis

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9
Q

Primary tuberculosis is clinically unrecognized 95% of the time.

A

true

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10
Q

The treatment of asthma is considered symptomatic.

A

true

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11
Q

Sarcoidosis is a disease that affects more than one organ/system.

A

true

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12
Q

Smoking is the cause, for most cases of primary lung cacinoma.

A

true

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13
Q

Exposure to asbestosis may cause lung cancer.

A

true

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14
Q

Respiratory infections are not that common.

A

false

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15
Q

The most common method of transmission of the common cold are:

A

respiratory droplets

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16
Q

Which of the following is the most common cause of allergic rhinitis?

A

pollen

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17
Q

We suspect a patient may be having an asthma attack if they present with signs and symptoms such as

A

wheezing, coughing, difficulties breathing

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18
Q

Atelectasis can be caused by a puncture to the pleura surrounding the lung.

A

true

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19
Q

Lung carcinoma is the most common malignant internal tumor in Canada.

A

true

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20
Q

Sarcoidosis presents with common signs and symptoms such as:

A

low grade fever and weight loss

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21
Q

Allergic rhinitis presents with:

A

nasal irritation

congestion

sneezing

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22
Q

A sleep disorder is which breathing stops and starts repeatedly.

A

sleep apnea

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23
Q

When an infant is born prior to 32 weeks and does not produce surfactant which respiratory disease do they have?

A

neonatal respiratory distress syndrom

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24
Q

A common term for atelectasis is which of the following?

A

collapsed lung

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25
Q

What is the catch all term of lung diseases caused by obstruction of the airways?

A

COPD

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26
Q

The following are all intrinsic factors of asthma except:

A

exposure to exogenous allergens

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27
Q

Pott’s disease presents with this common symptom seen by massage therapists:

A

back pain

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28
Q

Injury to the alveolar lining cells or endothelial cells is which of the following pathologies?

A

acute respiratory distress syndrome

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29
Q

Lung cancer originating from the lungs is more common than metastasis from other sites.

A

false

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30
Q

The most common cause of pneumonia is which of the following?

A

bacteria and virus

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31
Q

A pathological fracture is important to identify because:

A

The underlying disease must be identified

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32
Q

Which bone when fractured is important to identify with snuff box tenderness due to the risk of poor healing if not casted?

A

Scaphoid

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33
Q

Which of the following is a known risk factor for the development of osteoporosis?

A

Smoking

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34
Q

The supplementation of milk with Vitamin D is done to prevent which disease?

A

Osteomalacia

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35
Q

Which of the following is a risk factor for the development of osteoarthritis?

A

Obesity

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36
Q

Which metabolic product is the underlying problem in gout?

A

Uric acid

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37
Q

When surgery is required to align the bony pieces of a fracture it is called:

A

Open reduction

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38
Q

An imbalance between the synthesis and degradation of cartilage is the underlying cause of which disease?

A

Osteoarthritis

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39
Q

A person has a fall and their leg is externally rotated and shortened. What type of fracture is likely?

A

Hip

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40
Q

Congenital ‘brittle bone disease’ is known as:

A

Osteogenesis imperfecta

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41
Q

A 19-year-old man presents to his doctor with chronic knee pain and is eventually diagnosed with cancer. Which type of cancer best fits this presentation?

A

Osteosarcoma

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42
Q

Which two concurrent complaints go with discitis?

A

Back pain and fever

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43
Q

Which one of the following is a fracture associated with osteoporosis?

A

Compression fracture

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44
Q

Rheumatoid nodules are:

A

Granulomas found on extensor surfaces

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45
Q

Bacterial infection of the bone is known as:

A

Osteomyelitis

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46
Q

Rickets is known as:

A

Osteomalacia

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47
Q

The process during which bones forming a joint lose contact and become misaligned is known as which of the following?

A

Dislocation

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48
Q

Which joint in the body must be managed very carefully when a massage therapist is treating a person with Rheumatoid Arthritis

A

C1 - C2

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49
Q

One of your clients has been seeing you for pain in her leg for 6 treatments and has noticed no difference in her problem. On her 6th visit she reports suffering from fatigue and believes she is losing weight. Which referral is most appropriate?

A

Medical Doctor

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50
Q

Rheumatoid arthritis is a multi-system disease that involves more than just joints.

A

True

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51
Q

You observe a person drinking coffee and their hands look very malformed. They appear to have ulnar deviation of their wrists with swan neck deformities of their fingers. You think this person suffers from:

A

Rheumatoid arthritis

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52
Q

Which of the following presentations is more likely rheumatoid arthritis?

A

Symmetrical joint involvement

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53
Q

Which of the following is NOT a joint usually affected by degenerative joint disease (osteoarthritis)?

A

Elbow
[It affect weight bearing joints]

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54
Q

For any bone to heal properly it is important to have just the right amount of:

A

Load

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55
Q

Which disease is defined as the loss of bone mass / density?

A

Osteoporosis

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56
Q

The loss of continuity of the structure of a bone is known as:

A

Fracture

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57
Q

Which of the following should be considered a medical emergency?

A

Septic arthritis

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58
Q

Thickened and deformed bones due to abnormal restructuring of the bone, is characteristic of which disease?

A

Paget’s

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59
Q

When a fracture fragment penetrates the skin and is exposed to the environment the fracture is referred to as:

A

Open/compound fracture

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60
Q

Legg-Calve-Perthes disease is a children’s example of which disease of the head of the femur?

A

Avascular necrosis

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61
Q

Inflammation and pain of the 1st metatarsal phalangeal joint of the foot due to gout is known as:

A

Podagra

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62
Q

A pathology presenting with heartburn that is worse at night, chest pain, difficulty swallowing, and regurgitating your food is know as:

A

GERD

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63
Q

Crohn’s Disease often has a delayed diagnosis due to the original symptoms being non specific.

A

true

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64
Q

Diverticulitis is defined as:

A

inflammation and infection of the diverticulum

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65
Q

Which type of hernia is most common?

A

Inguinal

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66
Q

The most likely causes of Cirrhosis is:

A

Alcohol

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67
Q

Which of the following are forms of Inflammatory Bowel Disease (IBD)

A

Ulcerative Colitis
Crohn’s Disease

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68
Q

What are the signs and symptoms of Hep B?

A

Weakness, vomiting, measles like rash, dark urine

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69
Q

Signs and symptoms of a peptic ulcer include

A

pain 1-3 hours following a meal

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70
Q

The cause of Irritable Bowel Syndrome is unknown.

A

true

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71
Q

A patient of yours presents with a sudden fever and abdominal pain in the lower right quadrant. You refer to medical attention and suspect:

A

Acute Apendicitis

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72
Q

Signs and symptoms of gallstones are:

A

upper right quadrant pain, referred to back and right shoulder, indigestion

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73
Q

Acute Pancreatitis is often linked to which of the following:

A

Alcoholism

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74
Q

Cryptochidism is?

A

A congenital malpositioning of the testes outside their normal scrotal location

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75
Q

An STI that can reoccur

A

Genital herpes

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76
Q

An STI that doesn’t necessarily display signs and symptoms in females

A

Chlamydia

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77
Q

What is pelvic inflammatory disease?

A

Infection of the uterus, fallopian tubes or other reproductive organs

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78
Q

What is the current survival rate of testicular cancer?

A

more than 90%

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79
Q

What is prostatitis?

A

inflammation of the prostate

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80
Q

what urinary problems are associated with the carcinoma of the prostate?

A

urgency to void but cannot

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81
Q

What are the signs and symptoms of prostate cancer?

A

Massage therapist should remember back pain that is
unusual in it’s presentation

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82
Q

What virus is related to cervical carcinoma?

A

HPV

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83
Q

PAP smears in women decrease which type of cancer in women?

A

Cervical Cancer

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84
Q

In what stage of life is endometral adenocarcinoma most likely to occure?

A

Endometrial tumors
generally affects those entering
menopause

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85
Q

What is leiomyoma

A

Benign tumor originating from the
myometrium

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86
Q

what is endometriosis

A

Tissues of endometrium found outside
the uterus

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87
Q

what is vulvodynia

A

chronic pain or discomfort around the opening of
your vagina for which there is no identifiable cause and which
lasts at least 3 months.

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88
Q

the most common site for ectopic pregnancy is

A

Ampulla of the Fallopian tube

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89
Q

placenta previa is

A

placenta is covering the opening of
the internal o/s of the cervix.

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90
Q

Fibroadenoma is

A

Benign Breast Tumor

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91
Q

where are most breast tumors found? why?

A

45% tumors found in upper lateral quadrant

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92
Q

Where does breast cancer metastases occure

A

axillary lymph nodes.
Tumors may also metastasize to lungs, liver, brain, bones
and adrenal glands.

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93
Q

what is the clinical presentation of breast carcinoma?

A
  • Breast mass discovered by palpation
  • Tumor discovered by mammography
  • Pain (mastodynia) or painful breast
    mass
  • Nipple retraction, eczematoid reaction,
    or discharge
  • Distant metastases
  • Edema in the arm due to metastases to
    lymph nodes.
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94
Q

What is a stroke?

A

rapid onset of typical
neurological deficits due to injury to the
brain
o Can be due to occlusion of blood vessels,
bleeding, or low blood pressure

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95
Q

what are the causes of ischemic stroke?

A

Cerebral infarct / ischemic stroke is a stroke
due to occlusion of blood vessel supplying the
affect area of the brain
Caused by thrombotic (atherosclerotic artery)
occlusion or thromboembolic occlusion
(from heart chambers)

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96
Q

What are the signs and symtoms of cerebral infarction? Why is it important to recognise the signs and symptoms early?

A

Unilateral hemiplegia, loss of sensation, facial
droop, speech difficulties (aphasia), eye
deviation, loss of one side of vision
Recovery depends on amount of brain tissue
damaged
o Ranges from no deficits to death

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97
Q

What are the causes for horner’s syndrome?

A

stroke, TUMOUR or spinal cord injury.
If underlying condition resolved nerve
function may be restored.

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98
Q

where does the bleeding occur in an epideral hematoma, and subdural hematoma? which vessels have ruptured (generally)?

A

Epidural Hematomas (meningeal artery)
* Bleeding between the skull and
the dura
Subdural Hematomas (ruptured bridging veins)
* Bleeding located between the dura
mater and the arachnoid

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99
Q

what is the classic presentation of a subarachnoid hemorrhage?

A

(Aneurysms) Sudden onset of the worst headache of their life with or
without neck stiffness

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100
Q

What is the cause of global ischemia?

A

Condition that results from short term
drop in blood pressure

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101
Q

what is the type of cells in the CNS that are involved in the primary tumor?

A

glial cell

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102
Q

What are the most common infective agents in the CNS?

A

bacteria and
viruses

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103
Q

Define Meningitis

A

Inflammation of the meninges secondary to
infection

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104
Q

Define encephalitis

A

Inflammation / infection of brain
parenchyma

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105
Q

what causes poliomyelitis?

A

Polio

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106
Q

what are the signs and symptoms of poliomyelitis?

A

slight fever,
malaise, headache, sore throat and vomiting
Nonparalytic: moderate fever, headache, vomiting, lethargy, pain in the
neck, back, extremities and abdomen. Here muscle tenderness, weakness
and and spasms can be seen. Usually lasting 1-2 weeks
Paralytic: usually develops 5-7 days after a fever sets in. Signs and symptoms
similar to nonparalytic but here we see asymmetrical weakness of muscle,
loss of reflexes and paresthesia, eventually leading to paralysis, the level of
which depending on area of spinal column is being affected.

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107
Q

What cranial nerve is involved in bell’s palsy?

A

seventh cranial nerve
VII FACIAL

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108
Q

What is MS

A

Chronic debilitating disease thought to be
due to autoimmune process that results in
the patient’s immune system attacking the
myelination of the CNS

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109
Q

Differences between:
myelomeningocele
meingocele
spina bifida

A

Spectrum of disease that results from
incomplete or improper closure of the ‘neural
tube’ during intrauterine development
Three degrees of same problem
o Myelomeningocele
▪ Defect in back with protrusion of meninges and part
spinal cord
▪ Apparent at birth
o Meningocele
▪ Defect in back with protrusion of meninge
▪ Apparent at birth
Spina bifida
▪ Absence of musculoskeletal elements with possible
exposure of meninges/spinal cord to outside world

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110
Q

cerebral palsy is

A

A congenital Myopathy

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111
Q

what is the presentation of cerebral palsy?

A

Presents with floppy child syndrome
* Tremors
* involuntary movement
* Delays in motor and speech development
– Neurogenic atrophy of muscle tissue impairs the ability of the child
to move and many become confined to a wheelchair

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112
Q

how is cerebral palsy treated

A

supportive and symptomatic

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113
Q

what is a contusion

A

Bruising and small centers of bleeding in the tissue of the brain
secondary to trauma

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114
Q

what is a coup and a counter coup lesion?

A

Contusion
Coup - Anterior (SITE OF IMPACT)
Counter coup - Posterior

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115
Q

what is a concussion?

A

Concussion
▪ Poorly understood complex pathophysiologic process affecting
the brain, induced by traumatic biomechanical forces

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116
Q

what level os the spinal cord involves paralysis of the diaphram?

A

Injury at C4 level may result in
paralysis of the diaphragm

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117
Q

what is athetosis, dystonia, myoloconus and tics?

A

Athetosis: a condition in which abnormal muscle contractions cause
involuntary writhing movements. It affects some people with cerebral palsy,
impairing speech and use of the hands.
Dystonia: a state of abnormal muscle tone resulting in muscular spasm and
abnormal posture, typically due to neurological disease or a side effect of drug
therapy. Caused by injury to the basal ganglia
Myoclonus: spasmodic jerky contraction of groups of muscles. Eg. It occurs
just before falling asleep.
Tics: There are two types of tics – motor tics and vocal tics. These shortlasting sudden movements (motor tics) or uttered sounds (vocal tics) occur
suddenly during what is otherwise normal behavior. Tics are often repetitive,
with numerous successive occurrences of the same action. For instance,
someone with a tic might blink his eyes multiple times or twitch her nose
repeatedly

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118
Q

what is the primary symptom os alzheimer’s disease?

A

Dementia
o progressive loss of cognitive functions and a
functional decline (loss of memory predominates)

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119
Q

List the classic signs and symptoms of parkinson’s disease?

A

o Pill rolling tremor of hands worse at rest
o Mask like faces
o Soft voice
o Shuffling gait, instability
o Stooped posture

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120
Q

Why is huntinton’s disease often passed on to future generations?

A
  • First symptoms usually do not appear
    before midlife
    o Results in disease being past on as no
    manifestation until later in life
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121
Q

What is amyotrophic lateral sclerosis? Lou Gehrig’s Disease

A
  • Neurodegenerative disease
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122
Q

What are the signs and symptoms of amyotrophic lateral sclerosis?
Lou Gehrig’s Disease

A
  • Motor weakness and progressive
    wasting of muscles in the extremities
    (small hand muscles)
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123
Q

what is freidreich’s ataxia

A

neuromuscular disease
that mainly affects the
nervous system (spinal
cord and peripheral
nerves) and the heart

AGE 10-25

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124
Q

what is depression

A

a mood disorder in which people
show extreme and persistent sadness, despair,
and loss of interest in life’s usual activities.

125
Q

what is schizophrenia

A

psychological disorders
characterized by a lack of reality testing and by
deterioration of social and intellectual
functioning and personality beginning before age
45 and lasting at least six months.

126
Q

what is bipolar disorder

A

mood disorder that is characterized by
behaviour that vacillates between 2 extremes:
mania and despair.

127
Q

Head ache red flags

A

o Headache and fever - ?meningitis, encephalitis?
o Headache and stiff neck - ?meningitis, bleeding?
o Sudden onset of worst headache ever - ?sub
arachnoid bleed?
o Change in headache pattern - ?tumor?
o Headache worse in morning - ?tumor?
o Headache and vomiting - ?increase intracranial
pressure?
o Headache with neurological deficits - ?lesion?
o Headache post fall (especially in elderly, alcoholics,
use of blood thinners) - ? bleeding?
o Headache with fatigue, jaw ache, vision changes -
?temporal arteritis?

128
Q

should a therapist treat a client with an acute migraine? why or why not?

A

o Not the treatment for acute severe migraine
o Massage may trigger some
Massage best for tension type headaches
* Migraines may be hit and miss

129
Q

What is adhesive capsulitis (Frozen shoulder)

A

shoulder joint capsule thickens and tightens
around the shoulder joint restricting movement.

130
Q

what is the onset of adhesive capsulitis

A

sudden or gradual onset
from 45 to 60 years of age if it results
from causes other than trauma. It can occur at any age but
more commonly with increased age.

131
Q

what ROM’s are most often affected by adhesive capsulitis?

A

Abduction and External rotation

132
Q

what are the stages of healing associated with adhesive capsulitis?

A

1.Freezing (Painful stage)
* Lasts 6 – 12 weeks
* Most painful stage
* ROM is restricted, shoulder not as stiff
2. Frozen
* Pain usually eases
* Considerably more stiff
* Lasts 4 to 6 months
3. Thawing
* Gradually motions steadily improves over a lengthy period of
time
* Can last more than a year

133
Q

which ion deposits and causes bursitis?

A

Ca2+ deposits

134
Q

describe the presentation of acute bursitis?

A

Pain
with movements of the arm
especially abduction and
rotations.

135
Q

why is the supraspinatus tendon more prone to tendionitis?

A

*Most commonly impinged
tendon of the shoulder
*Poor O2
supply along with
amount of use tendon
receives greatly
compromises this tendon

136
Q

where is the supraspinatus tendon most likely impinged?

A

between the
acromion and head of
humerus

137
Q

what are the signs and symptoms of supraspinatus tendonitis?

A

pain

138
Q

what motions are most commonly associated with an infraspinatus tendonitis?

A

sustained abduction, external
rotation and overhead
activities

139
Q

what motions are most commonly associated with injury to the bicipital tendon?

A

overhead activities with
incorporation of flexion, and
rotation

140
Q

what is an impingement syndrome?

A

compromised space between the
coracoacromial arch and the proximal humerus

141
Q

what is a sprain?

A

– injury to a ligament

142
Q

what is a strain?

A

injury to a muscle or tendon

143
Q

why is GH dislocation common?

A

poor congruency of the
humeral head in glenoid fossa

144
Q

define epicondylitis of the elbow

A

overuse injuries, with
progressive tissue degeneration.

145
Q

what are the structues damaged in lateral epicondylitis of the elbow?

A
  • Characterized with pain on the lateral apsect of the
    elbow. Tennis elbow
146
Q

what are the structures damaged in medial epicondylitis of the elbow

A

Characterized with pain on the medial aspect of the
elbow. Golfers elbow

147
Q

what is the presentation of olecranon bursitis?

A

Pain and swelling in the elbow

148
Q

what are the signs and symptoms of De Quervian’s tenovaginitis?

A

pain at snuff box area and
distal lateral forearms with gripping
activities and into thumb. Resisted
thumb extension and abduction
increase pain, positive Finkelstein’s
test.

149
Q

what is Dupuytren’s contracture?

A

contracture of the palmer aponeurosis.

150
Q

What is a cervical strain?

A

an injury or impairment of the cervical region of the
spine due to overuse or overextension ”

151
Q

what is an acceleration injury?

A

Whiplash

152
Q

What is a deceleration injury?

A

Whiplash

153
Q

what are the questions you would ask some one involved in a car accident?

A

Head position
Height of passenger
Seat position
Headrest position
Speed and direction involved
* Rear, side or frontal impact
* What happened during the accident?
* Did you hit your head, loose glasses, dentures?
* Aids in determining severity of movement
* Where were you located in the vehicle?
* Passenger, driver, etc.
* Were you wearing your seatbelt
* Were you aware of the impending accident

154
Q

describe WAD 1

A

Complaint of neck pain, stiffness or tenderness
only; no physical (musculoskeletal or
neurological) signs; no muscle spasm

155
Q

Describe WAD 2

A

Complaint of neck pain, stiffness or tenderness;
decreased ROM and point tenderness; injury to
muscles, tendons, ligaments and joint capsules,
causing muscle spasm

156
Q

Describe WAD 3

A

Complaint of neck pain, stiffness or tenderness;
neurological signs including decreased or
absent tendon reflexes, weakness and sensory
deficit

157
Q

describe WAD 4

A

Complaint of neck pain and fracture or
dislocation

158
Q

what are the symptoms of a cervical strain?

A

sharp pain, stiffness when moving and
swelling.

159
Q

correlate the WAD injury to the type of accident?

A
  • Collision types
  • Type 1 collision: Rear impact
  • Type 2 collision: Side impact
  • Type 3 collision: Frontal impact
160
Q

Also gives stages of healing

A
  • Stage 1: Acute injury, inflammation phase, up to 72 hours postaccident.
  • Stage 2: Sub acute, repair phase, 72 hour to 14 days.
  • Stage 3: Remodelling phase, 14 days to 12 months or more.
  • Stage 4: Chronic, permanent.
161
Q

Does being aware of the accident increase your injury rate? why?

A

Injury is less severe if the person does not see the injury coming and is not
bracing for impact.

162
Q

what is the rate of MVA that result in cervical fractures?

A

80 % of all cervical fractures are due to MVA

163
Q

Before treating some one with a MVA, the clients should

A

When dealing with any rapid velocity injury it is
imperative that the patient have an x-ray to rule
out fracture.

164
Q

what screening tests should be done prior to commencing any massage treatment?

A

Questions/history/mechinism of injury
VBI/ROM/Cervical palpatory assessments

165
Q

which tests involve testing neurological structures in the Cervical spine?

A

Compression, decompression, spirlings, quadrant, maxmal foraminal

166
Q

Describe the symptoms of toritcollis?

A

abnormal
positioning of the head and neck realtive
to the body.

167
Q

Congenital tortocollis
* Treatment

A

– When found a birth, ROM exercises with toys
to utilize the visual reflex will assist in
stretching the affected musculature.
– Surgery may be required to removed severly
fibrotic tissues. Post surgery active pain free
ROM are acceptable and recommended.

168
Q

Acute acquired tortocollis
* Symptomology

A

– Can affect any age
– Sudden onset, patient my report just “waking up like
this”
– Head and neck are in typical “tortocollis” position
– Decreased ROM in SB away from affected side and
rotation towards affected side. There may also be
some neck flexion or extension
– Pain, especially on movement. Patients often do not
want to move head as it provokes great pain.

169
Q

define acute tubular necrosis

A

occurs after cardiac arrest
and any form of Hypotensive shock
(massive bleeding)

170
Q

what is nephroangioslcerosis?

A

Atherosclerosis of major arteries (aorta
and major branches of the renal artery)
may lead to decreased lumen and thus
decreased blood flow to kidneys.

171
Q

what is Wilm’s tumor?

A

Tumor of infancy and childhood
* Malignant tumor

172
Q

What is the age group affected by wilm’s tumore?

A

children

173
Q

What is the cause of most urinary tract infections

A

bacteria

174
Q

what is the most common form of UTI’s

A

Ascending Infections

175
Q

list the signs and symptoms of a bacterial infection of the kidney?

A

– fever, back pain over the kidneys, dysuria,
hematuria, and frequency are possible but
not necessary

176
Q

what are urinary stones>

A

crystalline structure of
material that the kidneys usually excrete in
urine.

177
Q

are urinary stones more common in men or women?

A

More common in men

178
Q

what are the signs and symptoms of urinary stones?

A

Severe and unrelenting pain
* Pain is caused by the stretching of the ureter due to the obstructing stone
– Hematuria
– Urinary colics (spasm of ureters)

179
Q

What is the potential danger of treating a patient with bilateral leg swelling, for a massage therapist?

A

we need to recognize
that we should not
attempt to change that
swelling as we may
overload the CV system
and stress the patient.

180
Q

define urinary incontinance

A

Inability to retain urine in the
urinary bladder.

181
Q

What are the categories of pituitary disease?

A

hyperfunction, hypofunction and localized mass lesion

182
Q

what are the signs and symptoms of acromegaly

A
  • Acromegaly (Post-puberty)
    – Enlargement of acral parts of
    the extremities (FINGERS, TOES, HANDS, TOUNGUE , JAW AND NOSE)
    – Enlarged internal organs
    (heart)
    – Metabolic disturbances (mass
    effects)
    – Headaches (mass effects)
183
Q

what are the differences between gigantism and acromegaly?

A
  • Gigantism (Pre-puberty)
    – Longitudinal skeletal growth
184
Q

what is diabetes insipidus?

A

Endocrine disorder of the
posterior pituitary affecting the
metabolism of water in the
body (lack of ADH)

CAUSED BY DECREASED BLOOD FLOW TO THE PITUITARY GLAND

185
Q

what are the signs and symptoms of diabetes insipidus?

A

– Polydipsia (excessive thirst)
– Polyuria (excessive urine
production)
– Dehydration

186
Q

What is empty sella syndrome and what is the cause?

A

disorder in which part of the skull where the pituitary gland is housed (sella turcica) is partially or fully filled with CSF (cerebrospinal fluid)
* Causes: Most are unknown (this is called Primary Empty Sella Syndrome, some are due to underlying
conditions (this is called Secondary Empty Sella
Syndrome)

187
Q

what are the causes of hyperthyroidism?

A

excess of thyroid hormones t3 t4
EXCESS OF FSH

188
Q

what is the cause of Grave’s disease?

A

Antibodies to the TSH
receptor on the surface of
the follicular cells which
stimulate production of
thyroid hormones.

189
Q

what is the unique sign and symptom of grave’s disease?

A

Bulging eyes (Only occurs with Graves
Disease and not other types of
hyperthyroidism)

Massage Considerations
* Heat intolerance

190
Q

define thyroid adenoma

A

Benign tumor of the
thyroid gland
Most adenomas are small,
well encapsulated with
fibrous tissue
composed of thyroid
follicles

191
Q

what is hashimoto’s disease?

A

– Thyroiditis—Hashimoto’s disease
* Often immune mediated
Slowly developing persistent
inflammation of the
thyroid gland
Autoimmune Disease

192
Q

what is a risk factor for thyroid carcinoma?

A

nuclear radiation

193
Q

Disturbances in the parathyroid can cause problems with what?

A

Bones are prone to fracture due to
decalcification.

194
Q

What is the cause of hyperaldosteronism?

A

in Calcium
Homeostasis

195
Q

what is the cause of the majority of endogenous hypercoritisolism?

A

hypersecretion of
ACTH due to pituitary adenoma in
endogenous hypercotisolism

196
Q

what is the most common cause of hypercortisolism?

A
  • Exogenous steroids is the most
    common cause of hypercortisolism.
    MOST CASES ARE DUE TO A PITUITARY ADENOMA
197
Q

What are the signs and symptoms of hypercortisolism?

A

Cushings Syndrome
* Central trunk obesity
* Moon Face
* Buffalo hump
* Striae of Skin (stretch marks)
* Pt’s red in face b/c of lots
blood, hypertension and thin
skin
* Glucose intolerance, diabetes
* Fatigue
* Mentally unstable

198
Q

What are the signs and symptoms of addisons disease?

A
  • Fatigue
  • Weight loss
  • Nausea
  • Hyperpigmentation of skin
  • Hypotensive
  • Syncope (loss of consciousness b/c
    of fall of bp)
    Massage Considerations:
  • Extremely susceptible to infections
  • Cannot tolerate stress or maintain
    many of the usual daily routines
  • Low NaCl, high K+ and low glucose
199
Q

What is neuroblastoma?

A

Tumor composed of
neuroblasts
(undifferentiated
precursor of neural
cells as well as
adrenal medullary
cells)

200
Q

What are the signs and symptoms os pheochromocytoma?
(Benign solid tumor
originating from the
adrenal medulla)

A
  • Hypertension
  • Light headed, dizziness
  • Heart lesion due to exposure to epinephrine and norepinephrine.
201
Q

what is diabetes mellitus

A

Is a consequence of absolute or relative
insulin deficiency or an abnormal
response of target tissues to insulin.

202
Q

what is the cause of majority of the signs and symptoms of pheochromocytoma?

A

exposure to epinephrine
and norepinephrine.

203
Q

what are the signs and syptoms of low blood pressure

A

fainting

204
Q

what considerations should a therapist consider when treating a diabetic client?

A

Massage Consideration
If patient presents with the following during a treatment
their blood glucose levels are high or hyperglycemia
– Sweet smelling breath (Ketoacidosis)
– Pt may smell like they have been drinking alcohol
– Lots of free fatty acids oxidized to ketones (acidic)
* If patient glucose levels are low or hypoglycemia
– Slurred Speech, dizziness, weakness, pallor, rapid heart rate,
excessive sweating.
– Have juice in clinic
– If pt’s blood glucose levels fall too far they may lapse into a
Diabetic Coma (Call Ambulance)

205
Q

What are the signs and symptoms of an insulinoma?

A
  • Hypoglycemia, syncope ( fainting after drop in
    bp)
  • Profuse sweating, especially after fasting
  • Tx with surgery
    Gastrinomas (Malignant)
    Signs and symptoms
  • Peptic Ulcers
206
Q

What is Idiopathic lower back pain?

A
  • LBP of a musculoskeletal origin (soft tissue
    damage)
  • Otherwise known as mechanical back pain
207
Q

will mechanical back pain resolve on its own?

A
  • Usually
208
Q

what is the cause of majority lower back pain?

A

due to soft tissue
problems (muscle or ligament strain, postural
abnormalities, poor muscle tone or neuromuscular
disease)

209
Q

how does a massage therapist manage and treat lower back pain?

A

Management and treatment
* Screen for more sinister diseases that present with back pain
* Cancer, osteomyelitis, osteoporosis, abdominal aortic aneurysm, kidney
disease, cauda equina syndrome, disc prolapse
* Do not over investigate
* X rays not generally helpful – almost everyone has ‘degenerative changes’ but
not everyone has back pain
* Reassure and manage symptoms
* Emphasis on transient nature of the problem while providing pain relief
* Address underlying weakness, flexibility, and weight problems
* Often recurrence can be minimized by addressing these common problems
* Early return to work
* Studies show excessive rest is detrimental to the patient
* Returning to work in any capacity improves outcomes
* If light duties are available they should be pursued and the patient sent
back to work on a progressive schedule targeted to complete duties as an
eventual goal

210
Q

what are the risk factors of lower back pain?

A
  • Gender
  • Repeatedly lifting of heavy objects
  • Weak core musculature
  • Adaptive muscle shortening due to static posture
  • Coughing
  • Disk degeneration
  • Osteoporosis
  • Spondylolisthesis
    Undertaking activity beyond physical limitations
    will be a large factor in contributing to LBP
    -changes in posture
211
Q

what is the correlation between activity levels and physical ablilities with reference to lower back pain?

A

Undertaking activity beyond physical limitations
will be a large factor in contributing to LBP

212
Q

should a therapist change postural deformities? why or why not?

A
  • Changes in this may create LBP
    To summarize not all cases of postural deformities will
    result in LBP
213
Q

Should employees return to work early? why or why not?

A
  • The longer someone is off work with back pain, the lower
    the probability that they will return to work.
214
Q

list the factors that attribute to delayed return to work?

A
  • Thoughts that the pain is work related
  • Psychologic distress
  • Psychosocial aspects of work
  • Compensation
  • Time off work
215
Q

define spinal stenosis?

A

abnormal narrowing of the spinal canal (central) or
intervertebral foramen (lateral).

216
Q

does loss of bone mass from osteoporosis cause lower back pain? what does?

A
  • Loss of bone does not cause LBP, the associated fractures
    or collapse of vertebra can cause.
  • Treatment concentrated on pain reduction, increasing
    exercise and functional activities. (weight bearing exercise)
  • Important for the patient to maintain bone mass, strength
    training, postural stability and reduce pain.
217
Q

what is a myotome?

A

muscles innervated by a single spinal nerve.
* To complete the testing the contraction must be held for a
minimum of 6 seconds to show weakness. Testing must be
compared bilaterally, however for safety reasons it is best to
complete the tests on each side separately

218
Q

What is the reccomended treatment for a patient with osteoporois?

A
  • Treatment concentrated on pain reduction, increasing
    exercise and functional activities. (weight bearing exercise)
  • Important for the patient to maintain bone mass, strength
    training, postural stability and reduce pain.
  • For the elderly, minimizing the risk of falls is important
219
Q

why is myotome testing unilateral for the lower extremity?

A

safety reasons it is best to
complete the tests on each side separately

220
Q

what should you do if the pain does not correlate with assessment findings?

A

encourage our
patient to see their physician.

221
Q

list come possible sinister causes of back pain?

A
  • Aortic Aneurysms
  • Paget’s Disease
  • Prostate Cancer
  • Bone Cancer
  • Kidney Stones
  • Many urinary pathologies present with “flank pain”
222
Q

what is the structure of intervertebral discs?

A
  • Annulus fibrosus: outer laminated portion of disc made up of 3 zones: An outer zone made up of fibrocartilage
  • End plate: is attached to the vertebrae and the
    intervertebral discs. It is made up of a bilayer of
    bone and cartilage.
  • Nucleus pulposus: Inner part of intervertebral discs. At birth
    it is made up of hydrophilic mucoid tissue which is gradually
    replaced by fibrocartilage with age
223
Q

how do intervertebral discs degenerate?

A

Degenerative changes occur with age. Discs breakdown with
age thru loss of fluid tears or cracks in annulus fibrosus. Discs
shrink.

224
Q

Define buldged disk

A

Protrusion/bulge of disc: disc bulges posteriorly without
rupture of the annulus fibrosus.

225
Q

define herniated disc

A
  • Extrusion/herniation: the annulus fibrosus is perforated and discal material (part of nucleus pulposus) moves into the
    epidural space.
226
Q

define sequestered dics

A
  • Sequestrated disc: formation of discal fragments from the
    annulus fibrosus and nucleus pulposus outside the disc
    proper
227
Q

where does the spine have a increased susceptibility to disc herniation?

A

Cervical and lumbar regions of the spine
are most susceptible to herniation due
to the increase in flexibility in these
areas.

228
Q

define referred pain

A
  • Pain originating from deep visceral structures
    that is perceived to come from somatic
    structures that share the same spinal segment
229
Q

how is sclerotomal pain described by the patient?

A
  • Usually described as deep aching and diffuse
230
Q

what are the causes of sclerotomal pain?

A

an injury of paraspinal muscles, ligaments, facet
joint capsules, discs or the dura mater

231
Q

what causes redicular pain?

A
  • Due to irritation of the spinal nerve root
  • If sensory (dorsal) root is irritated the patient often
    experiences sharp pain, numbness or tingling that is well
    localized
232
Q

how does client describe radicular pain?

A

pain, numbness, tingling there may be weakness
in muscles supplied by that nerve root. Reflexes would also
be decreased by this.

233
Q

Muscle strain
Cause
Symptoms
signs

A
  • Cause: Acute injury - such as sports, cumulative stress (standing at
    work)
  • Symptoms: diffuse and achy pain – bilateral or unilateral. Stiff and
    tight muscles reported by patient, especially with certain movements.
    Rest relieves pain. Acute problem – muscle spasm
  • Signs: Restricted ROM, Point tenderness, Passive motion not usually
    painful until full stretch is introduced
234
Q

Ligament sprain
causes
symptoms
signs

A

Cause: Are the same as muscle strain
Symptoms: Well localized pain and can be sharp in certain movements
Sign: Active and passive movements are painful. Resisted is not usually
painful
Takes longer to heal
Fibrosis may occur and feel like a thickening in lumbar fascia
* Grade of strains
* Grade I is stretching of the ligament or a very mild tear, with little or no instability at
the joint.
* Grade II is a more serious but still incomplete tear, with some looseness in the joint.
* Grade III is a completely torn or ruptured ligament. This is not a broken bone, but
can feel like one since it’s often impossible to put weight on the joint or use the
affected limb because the joint isn’t

235
Q

facet dysfunction
causes
symptoms
signs

A

Cause: Poor posture, muscle imbalance, muscle hypertonicity leading to
fatigue and deconditioning, subluxation, fixation, entrapped meniscoid
Symptoms: May be ‘painless’ to patient, May be sudden onset or
insidious, unilateral or bilateral, Can radiate to groin, gluteal or thigh
Signs: Decreased extension/side-bending and rotation, Palpation of
‘displaced’ bony anatomy (prominent TP), Hypertonicity and tenderness in
muscles of paravertebral spine

236
Q

SI joint dysfunction
causes
symptoms
signs

A

Cause: injured by trauma, such as a fall in buttock, repetitive
twisting motion such as in golf.
Risk Factors: leg length discrepancy, muscle imbalances, sustained
muscle tightness
Symptoms: pain in gluteal, groin and posterior thigh,Dull, sharp or
aching pain, Sometimes pain can radiate to below the knee
Signs: Pelvis malalignment. Subluxation, innominate rotation,
flares. Sacral dysfunction (torsions), positive Patrick’s

237
Q

Piriformis syndrome
causes
symptoms
signs

A
  • Causes: hypertonic piriformis mm. often caused by excessive sitting, SI
    joint dysfunction; or overuse resulting from pelvic obliquity that leads
    to weakness of the gluteus medius of the ipsilateral side (the piriformis
    will overwork trying to substitute as an abductor)
  • S&S:
  • Pain on climbing stairs or inclines(may run through buttocks, post
    thigh and lower leg), that increases when seated for prolonged
    periods,
  • decreased ROM in the coxa, especially medial rotation
  • Pain occurs in the middle of the buttock, and achy pain can radiate
    down the posterior thigh but rarely past knee.
  • Straight leg test with medial rotation increases pain and lateral
    rotation relieves pain
238
Q

coccydynia
causes
symptoms
signs

A

Cause: Fall on gluteals and childbirth can precipitate, Articular
and soft tissue changes (coccygeal ligamentous fibrosis, pelvic
floor spasm)
Symptoms: coccyx pain when seated, rarely refers to another
location
Signs: Indication of pain and thickening of coccygeal ligament

239
Q

arthritis
causes
symptoms
signs

A

Cause: Previous injury to facet joints, Sustained muscle
tension, Poor posture, Muscle imbalances, Obesity
Symptoms: dull, aching pain worse in the morning, improves
with movement, Diffuse stiffness in the low back
Signs: Chronic loss of extension of lumbar, Damage to facets

240
Q

Pelvis crossed syndrome
causes
symptoms
signs

A
  • Pelvis Crossed Syndrome
  • Imbalance between shortened and tight hip flexors and
    lumbar errector spinae mm. and the weakened gluteals
    and abdominal mm.
  • Results in anterior rotation of the pelvis and
    hyperlordosis of lumbar spine plus minimal hip flexion
  • Tight mm. : Piriformis, Hamstrings, ES, QL, RF, TFL,
    Iliopsoas
  • Weak mm.: Glute max, med. and min, Rectus
    abdominus, Vastus medialias and Lateralis
241
Q

What is scoliosis

A

lateral curvature of
the spine

242
Q

What is the difference between structural and non-structural scoliosis?

A

Non-Structural Scoliosis
* It is also known as Functional
scoliosis
* Causes: postural problems,
muscular imbalance, nerve root
irritation, inflammation,
contracture or compensation
from leg length discrepancies
* Signs and Symptoms: back pain,
lose flexibility, side-bending stays
symmetrical, and curve will
disappear when flexing forward
at waist.
* It is usually found in the cervicals,
lumbar or thoracolumbar.

Structural Scoliosis
Causes: a bony deformity which
may be congenital, acquired or
excessive muscle weakness (long
term quadriplegia)
* Idiopathic (genetic) 75-85%
* Wedge vertebrae
* Tumours, infection that cause
bone destruction
* Hemivertebrae: one half of
vertebrae malformed
* Failure of segmentation: failure
of growth in vertebrae bones
during embryonic development
Signs and Symptoms
* lose flexibility and may become
progressive
* Curve does not disappear with
forward flexion at waist
* Seen in thoracolumbar
* Side-bending not symmetrical
* Prominence of ribs on one side
* Compression and malposition of
the organs within rib cage
* Changes to discs, ligaments, joint
capsule and muscles
* Pain in back, neck, legs, hips

243
Q

What is scheuermann’s disease?

A

a type of structural
kyphosis. They get anterior
wedging of vertebrae.

244
Q

what is spondylosis?

A

a degenerative disease of unknown etiology
affecting intervertebral joints and resulting in exostoses
(bone spur) and ankylosis of adjacent vertebrae.

245
Q

what is spondylolisthesis

A

a forward displacement of one
vertebrae over another

246
Q

what is retrolisthesis

A

backward displacement of one vertebra on
another

247
Q

An ankle sprain is:

A

a tear or stretch of the ligature of the ankle

248
Q

Which pathology presents with the feeling of walking on stones, with calluses and inflammation around the joint capsule?

A

foot capsulitis

249
Q

This foot injury presents with pain at metatarsal heads especially during toe off in gait.

A

metatarsalgia

250
Q

Bone Spurs are created by pulling of the plantar fascia at the attachment site on the calcaneus and/or compressive forces.

A

true

251
Q

The ligature of the ankle that are most commonly sprained are the:

A

lateral collateral ligament

252
Q

During gait the plantar fascia serves to bring which structures of the foot closer together?

A

calcaneus and metatarsals

253
Q

When the bones of the midfoot are broken or dislocated with a bruise on the bottom of the foot we might suspect:

A

Lisfranc injury

254
Q

Which tendon has ruptured when there is a loud pop sound and severe pain in the heel and into calf?

A

achilles tendon

255
Q

The causes of plantar fasciitis are:

A

muscular imbalances

tibial displacements

overuse

256
Q

This foot deformity involves hyperextension of the MTP joint and flexion of the PIP joint.

A

hammer toe

257
Q

A tibial turned medially with toeing in, is called:

A

tibial torsion

258
Q

This pathology can cause a lack of sensation in the lower extremity and lead to Charcot’s arthropathy.

A

diabetes

259
Q

In this foot deformity clients lack a medial longitudinal arch.

A

pes planus

260
Q

A client with Plantar fasciitis might present with the following symptoms/pain pattern:

A

sharp pain in the morning when first stepping down and weight bearing

261
Q

Ankle sprains present with:

A

pain

swelling

decreased ROM

262
Q

In this foot deformity the big toe is lateral and its metatarsal is medial

A

hallux valgus

263
Q

Which motion serves to stretch the plantar fascia and increase pain for the patient?

A

pronation

264
Q

Where do bone spurs commonly occur when someone is suffering from plantar fasciitis?

A

medial anterior calcaneus

265
Q

In this ankle pathology the client lacks dorsiflexion because of muscle contracture or bone deformity.

A

ankle equinus

266
Q

A complete rupture of the Achilles tendon is treated with:

A

surgical reattachment:

267
Q

The underlying principle of pathophysiology behind a repetitive strain injury is best described as which of the following?

A

Localized inflammatory response

268
Q

Generally, overuse injuries start with discomfort after activity, and eventually progress to pain during and after the activity is stopped.

A

True

269
Q

Systemic pain is recognized with which of the following signs and symptoms?

A

Deep aching throbbing pain, interrupted sleep and is not aggravated by mechanical stress

270
Q

Repetitive strain injury can be defined as an “overuse syndrome that describes pain associated with loss of function which results from repetitive movements or sustained static loading”

A

True

271
Q

The intent of treatment is to address the musculoskeletal injuries and postural dysfunctions / imbalances.

A

True

272
Q

This pain is described as deep, boring and localized. What is it?

A

bone pain

273
Q

A thorough case history is important in helping determine the perpetuating cause of injury.

A

True

274
Q

The use of procedural protocol for postural control is not applicable when dealing with a repetitive strain injury.

A

false

275
Q

Repetitive strain injuries involve which of the following structures?

A

Muscles, nerves, tendons, ligaments, fascia and possibly bones

275
Q

Effective treatment of a repetitive strain injury is dependent on which of the following?

A

Recognizing and correcting the underlying predisposing, predicting, or perpetuating factors

276
Q

Client should only do passive rest when recovering from a RSI.

A

false

277
Q

What are the risk factors for RSI

A

Stress, postural faults, occupation, muscular imbalances

278
Q

What are the causes of repetitive strain injuries?

A

Muscular imbalances

Overtraining

Malalignment syndrome

279
Q

A benign pituitary tumor of the pituitary gland made from prolactin secreting cells

A

Prolactinoma

280
Q

Plasma protien that triggers coagulation and inflammation

A

Factor XII Hageman

281
Q

Proliferative stage engaged in fibroblasts migration and cap growth

A

Fibroblaisa and neuro vascularization

282
Q

Hyperplasia

A

Increase in number of cells

283
Q

Endothelium contributions to inflammation

A

Metaplastic transformation of WBCs

284
Q

In creased blood flow to cap bed due to pre-cap sphinter relaxation
Starlings equation

A

Blood hydrostatic pressure

285
Q

Transudate is plasma Ritch in protiens

A

FALSE

286
Q

How far cancer has spread

A

Stage

287
Q

Malaria

A

Protozoa

288
Q

Cause of edema

A

Increased intramuscular hydrostatic pressure

289
Q

Bacteria

A

Single cell
No nucleus

290
Q

Viruses

A

Protien coat
Nucleic acid

291
Q

Type 2 hyper sensitvity

A

Antibodies

292
Q

Autoimune in skin, joints and kidney

A

Systemic

293
Q

Problems due to medical or therapeutic intervention

A

Iatrogenic

294
Q

Type 1 hypersensitivity

A

IgE

295
Q

Type 4 hypersensitivity

A

Granulomas

296
Q

Type 3 hypersensitivity

A

Basement membrane

297
Q

Extracellular deposit of fibillary protiens causing malfunction of the organs

A

Amyloidosis

298
Q

Vitiligo is

A

Acquired

299
Q

Tinea versicolor

A

Fungal infection

300
Q

Autoimmune causing thickening of the skin and internal organs

Collagen

A

Scleroderma

301
Q

Polycthemia vera

A

Erthrocytes

302
Q

Wagerers granuloma

A

Blood vessels

303
Q

Multiple myeloma

A

Plasma cells

304
Q

Swollen red fingers with streaks

A

Lymphangitis

305
Q

Fever and painful lymph

A

Lymphenitis

306
Q

Buerger’s disease

A

Acute inflammation. And thrombosis of the arteries and veins usually in the hands and feet

307
Q

Infection that damages heart valve

A

Endocarditis

308
Q

Rheumatic heart diseas

A

Strep
Valvular

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